James M. Calloway

Individual provider Active NPI Professional Counselor · Mount Enterprise, TX

NPI 1013078096 · NPPES record last updated Oct 29, 2007

Key facts

NPI
1013078096
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
16448 (TX)
Practice address
704 W Rusk St
Mount Enterprise, TX 75681-7427
Phone
(903) 822-4014
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
16448TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ames Counseling and Family Services Professional Past Accepting new patients
Ames Counseling and Family Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 16448 TX Yes

Addresses

Primary practice location

704 W Rusk St
Mount Enterprise, TX 75681-7427

Mailing address

PO Box 696
Mount Enterprise, TX 75681-0696
Phone (903) 822-4014

Other identifiers

IdentifierTypeStateIssuer
LP0053183MedicaidTX

Other providers in Mount Enterprise, TX

All providers in Mount Enterprise, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.